Stool withholding is one of the most common — and most misunderstood — bowel problems in young children. It happens when a child deliberately tightens their pelvic floor muscles to prevent a bowel motion, usually because they are afraid it will hurt.

Why Do Children Withhold?

It often starts with a single painful experience. A hard, large, or scratchy stool causes pain or a small tear (anal fissure), and the child learns to associate going to the toilet with pain. To avoid this, they clench their bottom muscles whenever they feel the urge. This makes the problem worse: the longer stool sits in the rectum, the harder and more uncomfortable it becomes.

Common triggers include:

Signs Your Child May Be Withholding

Unlike simple constipation, withholding has some tell-tale signs:

Many parents mistake the stiffening posture for trying to push, when in fact their child is doing the opposite.

How Is Stool Withholding Treated?

The good news is that most children with stool withholding respond well to treatment. The goals are to:

Diet changes alone (more fibre and water) are helpful but rarely sufficient on their own.

When Should You See a Specialist?

See your GP or paediatric gastroenterologist if:

Dr Harveen Singh FRACP sees children with constipation and stool withholding at clinics across Sydney, including Bankstown, Westmead, St Leonards, and Campbelltown. A referral from your GP or paediatrician is required.

Last reviewed by Dr Harveen Singh FRACP, Paediatric Gastroenterologist & Hepatologist